A Description of the Lung Disease Found in Iranian Women Exposed to Dung Smoke

Background: Indoor air pollution other than smoking is an important factor affecting lung and is a major risk factor for chronic obstructive pulmonary disease (COPD) especially in developing countries. In Iran, the majority of housewives in rural communities use biomass fuel for cooking and space heating even in the living room, which is a common practice in winter. An attempt has been made to test the hypothesis that wether a relationship exists between the use of biomass fuel and chronic bronchitis in women who bake bread in a domestic setting. Methods: This study was performed in pulmonary ward and outpatient clinics of Imam Khomeini hospital of Tabriz Iran university of medical sciences from November 2004 to march 2008.Forty two patients who were diagnosed with chronic bronchitis based on American Thoracic Society (ATS) criteria enrolled in our study. Data regarding historyand physical examination were collected for each patient. Chest X-ray, ECG, serum IgE, spirometry and transthoracic echocardiography were performed. Results: All patients fulfilled the criteria for COPD. Eighty five percent of patients had radiographic abnormalities. Seventy three percent of them had spirometric impairments. Serum IgE level in all of the cases were in the normal range. Significant pathologic findings were reported in all of the nine patients who underwent fiberoptic bronchoscopy for hemoptysis. Conclusions: COPD is not uncommon among non-smokers and risk factors other than active cigarette smoking, such as biomass smoke, may contribute to airways obstruction and sometimes restrictive disease ,severe pulmonary artery hypertension and significant pathologic changes. A new strategy in cooking in rural areas should be applied by governments.